Individual
WILLIAM DERRICK THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2400 BELLEVUE ROAD, 18 ERIN OFFICE PARK, DUBLIN, GA 31021
(478) 272-5933
(478) 272-4350
Mailing address
2400 BELLEVUE ROAD, 18 ERIN OFFICE PARK, DUBLIN, GA 31021
(478) 272-5933
(478) 272-4350
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT002129
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100623
AVESIS
GA
01
—
34465
OPTICARE
GA
05
—
907034188A
—
GA
05
—
907034188B
—
GA
01
—
966871
BLUE CROSS
GA
01
—
P00055084
RAILROAD MEDICARE
—
Enumeration date
07/21/2006
Last updated
06/20/2024
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